ECMO

Question 1

normal postoxygenator PaO2 levels?

Answer 1

> 400 mmHg

Question 2

if the preoxygenator levels are elevated in VV ECMO what are you concerned about?

Answer 2

recirculation

Question 3

what is recirculation?

Answer 3

patients on VV ECMO who have systemic hypoxia despite adequate oxygenation from oxygenator

Question 4

how does recirculation occur?

Answer 4

reinfused oxygenator blood returning from ECMO circuit is withdrawn throuhg the drainage cannula without passing through systemic circulation

Question 5

why is recirculation more common in 2 site VV ECMO?

Answer 5

the reinfusion jet is directed at the drainage cannula, if they are in close proximity the risk for recirculation is higher

Question 6

what is the best setup to prevent recirculation?

Answer 6

right IJ infusion, left fem drainage

Question 7

recirculation is more likely to occur at ___ flow rates? why?

Answer 7

high

- high flow rates can increase the negative pressure at the drainage cannula and pull more fluid from reinfusion cannula